戴人谓∶肝屡谋，胆屡不决，屈无所伸，怒无所泄，肝木胆火随炎入心，心火炽亢，神不守
舍，久逆而成癫狂，一因也。
有思虑过多，脾伤失职，心之官亦主思，甚则火炽，心血日涸，脾液不行，痰迷心窍，以致
癫狂，二因也。
古方每以癫、痫并治，出方乃大误也。盖癫为心病，而属实者多，痫为五脏兼病，而属虚者
多。盖因《灵枢》一云∶癫痫螈 ，不知所苦。后人不察，遂认为一证。殊不知《灵枢》自以两
证而言，不知所苦，皆言不能自知其病之所苦也，《玉机微义》始分别之，而亦未尝白《灵枢》之
旨也。
脉大坚实者，癫狂。脉虚弦为惊。沉数为痰热。脉大而滑者，自已。沉小急实者，死。虚而
弦急者，死。
寸口脉沉大而滑，沉则为实，滑则为气，实气相搏，入脏则死，入腑则愈。丹溪曰∶癫狂
脉虚易治，实者难治。
登高弃衣，引重致远者为癫，乃痰火亢炽之甚而然。治宜降下之剂，滚痰丸之属是也。
自高辩智，妄语狂言，神明失守为狂。治宜镇心安神清上之剂，牛黄朱砂丸之属是也。
张子和治癫狂，令患人于燠室中，先涌痰二、三升，后与承气汤一、二升顿服，大下二十
行，而病即宁。
清心汤 治心受热邪，狂言叫骂，动屐失常。
黄连 黄芩 薄荷 连翘 栀子 甘草 大黄 芒硝（各等分）
上水盏半，竹叶十个，煎八分，温服。
（《局方》）牛黄清心丸 治心志不足，神气不定，惊恐癫狂，语言谵妄，虚烦少睡，
甚至弃衣登高，逾墙上屋等证。
羚羊角（镑，一两） 人参（二两半） 白茯苓 川芎 防风（各半两） 阿胶（炒，七钱半）
干姜（炮，七钱） 白术（两半） 牛黄（各两半） 麝香（半两） 犀角（镑，二两） 雄黄（研飞，
八钱） 梅花冰片（五钱） 金箔（一千四百片） 白芍药 柴胡（各两半） 甘草（炒，五两）
山药（七两） 麦门冬（去心） 枯黄芩（各两半） 杏仁（泡，去皮、尖及双仁者，面炒黄色，另研用）
桔梗（各二两二钱） 神曲（二两半） 大枣（一百枚，蒸熟，去皮、核，另研成膏） 白蔹（七钱半）
蒲黄（炒，二两半） 大豆黄卷（一两七钱半，微炒） 当归（酒洗） 肉桂（去皮。各一两七钱）
上除枣、杏仁、金箔、二角及牛黄、脑、麝、雄黄四味，为末入药和匀，炼蜜同枣膏和丸，
每两分作十丸 将前金箔除四百片为衣。每服一丸，食后温水化下。
朱雄丸 治男女惊忧失志，思虑过多，痰迷心窍，以致叫呼奔走。此药安魂定魄。
辰砂 明雄黄（各二钱半，研） 白附子（一钱）
上研末，猪心血丸，金箔为衣。每服三丸，人参、菖蒲煎汤下。
抱胆丸 治男女一切癫狂风痫，及妇人产后惊气入心，室女经行惊气蕴结，顿服此药屡效。
朱砂（二两） 水银（一两） 黑铅（两半） 乳香（一两，细研）
上将铅入铫内，下水银结成砂子，下乳香，乘热用柳木捶擂匀，丸如鸡头子大。每服一丸，空
心井花水吞下。得睡切莫惊动，觉来则安，再进一丸可除根。
引神归舍丹 治癫狂心风，心气不足。
朱砂 胆南星（各一两） 白附子（半两）
上为细末猪心血泡，蒸饼为丸，梧桐子子大，每服十五丸。
五胆丸 治癫狂风痫妄走。
羊胆 猪胆 狗胆 鸡胆 鲤鱼胆（各一枚，倾汁作一处） 蛇黄（五两， 红，食胆汁尽
为度）
上为末，另以胆汁和丸，绿豆大，朱砂为衣。每服十五丸，食后以磨刀汁吞下，或用末以磨刀
水调服。
滚痰丸 治癫狂热盛，不识人。（方见痰门。）
夺命散 治癫痫痰盛。
青礞石（每两用火硝一两和，同炼如金色，研末。每服一钱。薄荷自然汁加蜜调下，良久，
其药自裹痰下坠，甚者三服愈。）
牛黄丸 治癫狂风痫，心风，邪气惊心，神不守舍，时发无常，仆地吐涎，不自知觉。
牛黄 珍珠 麝香（各五分） 朱砂 龙齿（各另研） 犀角 琥珀（各二钱） 天门冬（去心）
人参 茯苓（各四钱） 水银（五分） 麦门冬（去心，四钱） 防风 黄芩 知母 龙胆草 石菖蒲
白芍药 全蝎 甘草（各半两） 露蜂房（三钱） 金箔 银箔（各七十片）
上除另研药外，余为细末，共和匀，入炼蜜和捣千杵，丸如梧桐子大。每服十五丸，食后临
夜新竹叶汤下。
郁金丸 治癫狂多年不愈，痰迷心窍，惊忧得之。
蝉肚郁金（真蜀地者六两） 明矾（三两，共为细末）
上为薄糊丸，梧桐子大。每服五十丸，白汤下。
黄石散 治心风发狂。
狗肝（一具） 硝石 黄丹（各一钱半）
上以狗肝切开，二药为末擦肝内，麻缚住，水一升煮熟，嚼津咽。
三黄丸（方见火门） 以朱砂为衣，常服治癫狂痫。
一醉散 治心风发狂。
无灰酒（二碗） 麻油（四两）
上二味和匀，于锅内慢火熬，以柳条二十根搅百下，如膏，至八分。灌病患饮尽，令熟
睡，或吐或不吐，
觉来自定。
牛黄泻心汤 治心经邪热，狂言妄语，心神不安。
牛黄（另研） 冰片（另研。各一钱） 朱砂（另研，二钱） 大黄（生用，一两）
上为细末，和匀。每服三钱，凉生姜汤、蜜水调下。
Dai Ren stated: The Liver frequently plans, but the Gallbladder repeatedly hesitates. Grievance has no outlet for extension, and anger has no channel for release. Liver Wood Qi and Gallbladder Fire ascend together to inflame the Heart. When Heart Fire becomes blazing and hyperactive, the Shen (Spirit) fails to reside in its abode. Long-term rebellion of Qi leads to Dian-Kuang (Epilepsy-Mania complex), which is the first cause.
If there is excessive thinking, the Spleen is injured and loses its function. Since the Heart's organ also governs thinking, excessive thinking causes Fire to blaze. Heart Blood dries up day by day, and Spleen fluids fail to circulate. Phlegm confuses the Heart orifices, leading to Dian-Kuang, which is the second cause.
Ancient formulas often treated Dian (Manic-Depressive Psychosis) and Xian (Epilepsy) together, issuing the same prescription; this is a major error. Dian belongs to the Heart and is mostly excess syndrome; Xian involves multiple Zang-Fu organs and is mostly deficiency syndrome. This likely stems from a statement in *Ling Shu*: "Epileptic convulsions, unaware of their suffering." Later scholars failed to examine this carefully and thus considered them one syndrome. It is unknown that *Ling Shu* originally discussed these as two separate syndromes. "Unaware of their suffering" means the patient does not know where the pain lies. *Yu Ji Wei Yi* began to distinguish between them, yet still did not clarify the intent of *Ling Shu*.
A pulse that is large and firm indicates Dian-Kuang. A pulse that is deficient and wiry indicates Jing (Fright). A pulse that is deep and rapid indicates Tan-Re (Phlegm-Heat). A pulse that is large and slippery indicates spontaneous recovery. A pulse that is deep, small, urgent, and solid indicates death. A pulse that is deficient, wiry, and urgent indicates death.
At the Cun Kou (Radial artery) position, a pulse that is deep, large, and slippery: Deep indicates Shi (Excess), Slippery indicates Qi stagnation. When Excess and Qi struggle, if the pathogen enters the Zang organs, it leads to death; if it enters the Fu organs, recovery occurs. Dan Xi said: Dian-Kuang with a deficient pulse is easy to treat; with an excess pulse, it is difficult to treat.
Climbing high and discarding clothes, carrying heavy weights over long distances characterizes Dian, caused by extreme hyperactivity of Tan-Huo (Phlegm-Fire). Treatment should employ descending agents, such as Gun Tan Wan (Rolling Phlegm Pill).
Thinking highly of oneself, being eloquent, speaking nonsense and madness, with loss of mental control characterizes Kuang (Mania). Treatment should employ agents to calm the Heart and Spirit and clear the upper jiao, such as Niu Huang Zhu Sha Wan (Calculus Bovis and Cinnabar Pill).
Zhang Zi He treated Dian-Kuang by placing the patient in a warm room, first inducing vomiting to expel two or three sheng of phlegm, then administering Cheng Qi Tang (Gut-Purging Decoction) one to two sheng in a single dose. After profuse diarrhea of twenty times, the illness immediately settled.
Qing Xin Tang (Clear Heart Decoction): Treats Heat-Evil invading the Heart, causing rambling speech, cursing, and abnormal movements.
Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Bo He (Menthae Haplocalycis Herba), Lian Qiao (Forsythiae Fructus), Zhi Zi (Gardeniae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma), Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas) (equal parts).
Take one and a half cups of water, add ten Zhu Ye (Bambusae Folium), decoct to eight-tenths volume, and take warm.
(Niu Huang Qing Xin Wan [Calculus Bovis Clear Heart Pill] from *Ju Fang*): Treats insufficiency of Heart will, unsettled Shen-Qi, fright-induced Dian-Kuang, delirious speech, empty vexation with little sleep, and even symptoms like discarding clothes, climbing high, or jumping over walls.
Ling Yang Jiao (Capricornis Cornu, sliced, 1 liang), Ren Shen (Ginseng Radix, 2.5 liang), Bai Fu Ling (Poria, 0.5 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 0.5 liang), Fang Feng (Saposhnikoviae Radix, 0.5 liang), E Jiao (Colla Corii Asini, stir-fried, 7.5 qian), Gan Jiang (Zingiberis Rhizoma, processed, 7 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1.5 liang), Niu Huang (Calculus Bovis, 1.5 liang each), She Xiang (Moschus, 0.5 liang), Xi Jiao (Rhinocerotis Cornu, sliced, 2 liang), Xiong Huang (Realgar, refined, 8 qian), Mei Hua Bing Pian (Borneolum Syntheticum, 5 qian), Jin Bo (Folium Aurum, 1400 pieces), Bai Shao Yao (Paeoniae Radix Alba, 1.5 liang each), Chai Hu (Bupleuri Radix, 1.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, stir-fried, 5 liang), Shan Yao (Dioscoreae Rhizoma, 7 liang), Mai Men Dong (Ophiopogonis Radix, dehearted), Ku Huang Qin (Scutellariae Radix, 1.5 liang each), Xing Ren (Armeniacae Semen, soaked, skin and tip removed, double-kernel removed, stir-fried with flour until yellow, separately ground), Jie Geng (Platycodonis Radix, 2.2 qian each), Shen Qu (Massa Medicata Fermentata, 2.5 liang), Da Zao (Jujubae Fructus, 100 pieces, steamed ripe, skin and pits removed, separately ground into paste), Bai Lian (Angelicae Dahuricae Radix, 7.5 qian), Pu Huang (Typhatis Pollen, stir-fried, 2.5 liang), Da Dou Huang Juan (Sojae Semen Praeparatum, 1.75 liang, lightly stir-fried), Dang Gui (Angelicae Sinensis Radix, wine-washed), Rou Gui (Cinnamomi Cortex, bark removed, 1.7 qian each).
Except for the dates, almonds, gold leaf, rhino/antelope horns, and the four substances Calculus Bovis, Borneolum, Moschus, and Realgar which are handled separately, grind the rest into fine powder, mix evenly, combine with refined honey and date paste to form pills. Each liang of powder makes ten pills. Take 400 pieces of gold leaf as coating. Take one pill per dose, dissolved in warm water after meals.
Zhu Xiong Wan (Cinnabar and Realgar Pill): Treats men and women suffering from fright, sorrow, lost will, excessive thinking, causing Phlegm to confuse the Heart orifices, resulting in shouting and running. This medicine calms the Hun and stabilizes the Po.
Chen Sha (Cinnabaris, 2.5 qian each, ground), Ming Xiong Huang (Realgar, 2.5 qian, ground), Bai Fu Zi (Typhonii Rhizoma, 1 qian).
Grind into powder, make pills with Pig Heart Blood, coat with gold leaf. Take three pills per dose, washed down with decoction of Ren Shen and Chang Pu.
Bao Dan Wan (Gallbladder-Embracing Pill): Treats all cases of Dian-Kuang wind-Xian in men and women, postpartum fright entering the Heart in women, and menstrual fright accumulation in unmarried girls. Taking this medicine once yields frequent efficacy.
Zhu Sha (Cinnabaris, 2 liang), Shui Yin (Hydrargyrum, 1 liang), Hei Qian (Plumbum, 1.5 liang), Ru Xiang (Olibanum, 1 liang, finely ground).
First place lead in a crucible, add mercury to form cinnabar grains, then add olibanum. While hot, beat and mix evenly with a willow wood pestle. Form pills the size of a corn kernel. Take one pill per dose, swallowed with well water on an empty stomach. Sleep after taking; do not disturb. Upon waking, the condition stabilizes. Administer another pill to eradicate the root.
Yin Shen Gui She Dan (Guiding Spirit Returning to Abode Pill): Treats Dian-Kuang wind-pathogen affecting the Heart, Heart Qi insufficiency.
Zhu Sha (Cinnabaris), Dan Nan Xing (Arisaematis Cum Bile, 1 liang each), Bai Fu Zi (Typhonii Rhizoma, 0.5 liang).
Grind into fine powder, soak in Pig Heart Blood, make pills with steamed leavened dough, size of Sophora seeds. Take fifteen pills per dose.
Wu Dan Wan (Five Gall Bladders Pill): Treats Dian-Kuang wind-Xian with wandering and delirium.
Yang Dan (Ovis Gallbladder), Zhu Dan (Sus Scrofa Gallbladder), Gou Dan (Canis Gallbladder), Ji Dan (Galli Gallbladder), Li Yu Dan (Cyprinus Carpio Gallbladder) (one of each, extract juice and mix together), She Huang (Reptilis Gallbladder, 5 liang, calcined red until bile is consumed).
Grind into powder. Mix with gallbladder juice to form pills, size of mung beans, coat with Cinnabaris. Take fifteen pills per dose, swallowed with grinding-water after meals, or take powder mixed with grinding-water.
Gun Tan Wan (Rolling Phlegm Pill): Treats Dian-Kuang with intense heat, failing to recognize people. (Formula see Phlegm Section.)
Tuo Ming San (Life-Snatching Powder): Treats Epilepsy with abundant phlegm.
Qing Meng Shi (Calcareous Schist, process 1 liang with 1 liang Fire Nitre, smelt until golden color, grind to powder. Take 1 qian per dose. Mix with fresh Mint juice and honey, take orally. After a while, the medicine wraps the phlegm and pushes it down. Severe cases cured in three doses.)
Niu Huang Wan (Calculus Bovis Pill): Treats Dian-Kuang wind-Xian, Heart wind, evil qi startling the spirit, Shen not residing in its abode, irregular attacks, falling to ground and salivating, unaware of self.
Niu Huang (Calculus Bovis), Zhen Zhu (Margarita), She Xiang (Moschus) (each 5 fen), Zhu Sha (Cinnabaris), Long Chi (Dent Draconis) (each separately ground), Xi Jiao (Rhinocerotis Cornu), Hu Po (Electrum) (each 2 qian), Tian Men Dong (Asparagi Radix, dehearted), Ren Shen (Ginseng Radix), Fu Ling (Poria) (each 4 qian), Shui Yin (Hydrargyrum, 5 fen), Mai Men Dong (Ophiopogonis Radix, dehearted, 4 qian), Fang Feng (Saposhnikoviae Radix), Huang Qin (Scutellariae Radix), Zhi Mu (Anemarrhenae Rhizoma), Long Dan Cao (Gentianae Radix), Shi Chang Pu (Acori Tatarinowii Rhizoma), Bai Shao Yao (Paeoniae Radix Alba), Quan Xie (Scorpio), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang), Lu Feng Fang (Vespa Nidus, 3 qian), Jin Bo (Folium Aurum), Yin Bo (Folium Argentum) (each 70 pieces).
Except for those requiring separate grinding, grind the rest into fine powder, mix evenly, add refined honey, pound a thousand times, form pills size of Sophora seeds. Take fifteen pills per dose, washed down with fresh Bamboo Leaf decoction after meals and before night.
Yu Jin Wan (Curcuma Pill): Treats Dian-Kuang persisting for years, Phlegm confusing Heart orifices, caused by fright and sorrow.
Chan Du Yu Jin (Curcumae Radix from cicada abdomen, authentic Sichuan origin, 6 liang), Ming Fan (Alumen, 3 liang, grind together into fine powder).
Make pills with thin paste, size of Sophora seeds. Take fifty pills per dose, washed down with plain boiled water.
Huang Shi San (Yellow Stone Powder): Treats Heart wind causing mania.
Gou Gan (Canis Hepatis, one piece), Xiao Shi (Natrii Nitrates), Huang Dan (Minium) (each 1.5 qian).
Cut open the dog liver, rub the two powders inside the liver, tie tightly with hemp, cook in one sheng of water. Chew and swallow the saliva/juice.
San Huang Wan (Three Yellows Pill) (Formula see Fire Section): Coat with Cinnabaris. Regular use treats Dian-Kuang-Xian.
Yi Zui San (One Drunkenness Powder): Treats Heart wind causing mania.
Wu Hui Jiu (Pure Wine, two bowls), Ma You (Sesami Oil, 4 liang).
Mix the two ingredients, slowly boil in a pot, stir one hundred times with twenty willow twigs until paste-like, reduce to eight-tenths volume. Pour and have the patient drink completely, causing deep sleep. Whether vomiting occurs or not, upon waking, the mind settles naturally.
Niu Huang Xie Xin Tang (Calculus Bovis Draining Heart Decoction): Treats Evil Heat in Heart Channel, rambling speech, unsettled Shen.
Niu Huang (Calculus Bovis, separately ground), Bing Pian (Borneolum Syntheticum, separately ground) (each 1 qian), Zhu Sha (Cinnabaris, separately ground, 2 qian), Da Huang (Rhei Radix et Rhizoma, raw, 1 liang).
Grind into fine powder, mix evenly. Take 3 qian per dose, mixed with cool Ginger decoction and honey water.